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Thursday, May 21, 2009

Blumenthal at Brookings

The important part of supporting the nation’s healthcare IT initiatives is to back healthcare reform, said David Blumenthal, MD, the national coordinator for health information technology and the Obama administration’s top health information appointee. “We will not succeed in our agenda unless reform succeeds,” Blumenthal said Wednesday during a healthcare forum at the Engelberg Center for Health Care Reform of the Brookings Institution in Washington, D.C. He also noted that there’s considerable skepticism about the $20 billion in the stimulus package to further adoption of health IT that it will deliver on promises to improve quality and lower costs. But he said it can play a “critical” role in a reformed health system because of the need for information technology in health care decision making.

Blumenthal also talked about stimulus money for healthcare IT and the "meaningful use” of information technology in healthcare. He said the use of electronic health records in his own practice had made him a better doctor, and he envisioned a day when IT would be as common as a stethoscope in a physician’s practice and IT skills would become part of the licensing process. “It’s going to be ultimately incorporated in the culture,” he said. Blumenthal said that his own office has moved into sharp focus since the stimulus passed because his budget has grown from $60 million to $2 billion, including grant programs it will handle for programs such as building up a health IT workforce, establishing resources to help providers adopt the technology and aiding the creation of broad health care information networks. He said his priorities include providing a definition for "meaningful use" of healthcare IT, as required by ARRA. "There is obviously an enormous amount of expectation about that,” he said. He said the definition would “focus us on the outcome of adoption rather than on the process of adoption.” He claimed they will seek much public input in developing a regulation governing incentive Medicare and Medicaid payments to doctors who make “meaningful use” of the technology. Blumenthal said the definition won’t appear “fully formed” from the federal government without “enormous” public input. The term “meaningful use” is focusing policy makers on payment for the outcomes of the use of the technology rather than on the processes involved in the technology. “We’re going to have to talk about what we will measure to decide whether meaningful use is occurring; an enormous challenge in itself,” he noted. He seems to realise that there is need to understand things from the provider’s perspective. “We are very sensitive to the need for hands-on technological support at the point of adoption,” he said. “We understand that that is a critical ingredient to success.” He also touched on health information exchanges during his keynote address. The stimulus package includes least $3 million to promote HIE at regional and sub regional level. The ONC will provide an outline for a program this spring or early summer. He also briefly mentioned privacy and security. “Privacy and security is very much on our minds,” he said. “If there is not trust in this system, it will not be acceptable to the American people.”